Processing Speed: What Music Therapists Should Know

What do you do when a client throws something or takes a swing at you?  How long does it take you, the therapist, to figure out what to do?  The amount of time depends on the therapist’s processing speed.  Processing speed is the amount of time between stimulation (seeing the wind up for a throw or punch) and beginning your response.  When clients presented challenging behaviors, I often felt that I took way too long to decide what to do. I wondered, Can I improve my processing speed, or is it a fixed trait?

Contrary to my initial belief, processing speed is something that can be improved with practice, and it is not correlated with intelligence.  What we mean by processing speed is how long it takes neurons to pass along information (Stevens, 2014). Strengthening connections between neurons allows neural impulses to travel faster (Stevens, 2014).  The brain makes connections while we sleep, which is one of the reasons why getting 7-8 hours of sleep per night is so important (National Institute of Neurological Disorders and Stroke, 2019). Sleep helps with learning, problem solving, and memory, all of which play into the amount of time it takes to interpret the situation and develop a response (NIH, 2019).  Long-term sleep deficiency can also increase the risk of vascular problems such as heart disease and high blood pressure, which can deprive neurons of oxygen and glucose, causing them to deteriorate (Walker, 2014).

Another reason adequate sleep is vital for increases in processing speed is that brain cells called glial cells grow and change the most during sleep.  Some glial cells wrap around axons to create myelin sheaths from proteins and fatty substances. Myelin sheaths insulate axons to keep electrical activity from inappropriately discharging, but more importantly, they substantially expedite the flow of electricity to the next glial cell.  Stevens (2014) writes that myelin sheaths are like flying to a destination instead of driving there. (Stevens, 2014)

Image: Stevens (2014)

While learning a new task (such as how to respond to challenging behaviors), glial cells increase in number and size.  Scientists do not yet know what causes glial cells to grow, but it is clear that they decrease the amount of time it takes for an electrical signal to pass to the next neuron in the network.  As the number of axons increases and the connections between cells grow stronger, the behavioral response becomes faster until it is automatic. This is why tasks such as driving take a lot of effortful processing at first, but over time become automatic. (Stevens, 2014).

The bottom line is, there’s hope for slow processors like me!  As the connections in my brain grow stronger from repetition (aka clinical experience), it takes less time to interpret the situation and respond.  I’ve found it helpful to write in my session plans redirection strategies and sensory regulation interventions that have worked for the client before.  Sometimes I mentally rehearse short, efficient redirections ahead of time, especially for clients with limited receptive language. As I my processing speed increases, I can use more of each session to help the client work toward their goals.

-Molly, Music Therapy Intern

 

References

National Institute of Neurological Disorders and Stroke. (2019). Brain Basics: Understanding Sleep [Web page]. Retrieved from: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep

Stevens, A. P. (2014). Learning Rewires the Brain [Web page]. Science News for Students. Retrieved from: https://www.sciencenewsforstudents.org/article/learning-rewires-brain

Walker, H. (2014). Slow Processing Speed, and How Can the Rate Be Improved? [Web page]. Scientific American. Retrieved from: https://www.scientificamerican.com/article/what-causes-the-brain-to-have-slow-processing-speed-and-how-can-the-rate-be-improved/

 

Repertoire Refresh: Meet Caspar Babypants

When many of your clients are small children, it can be hard to keep your repertoire fresh.  What do you do if a client is tired of “Old MacDonald” and “The Itsy Bitsy Spider”? What can you as the therapist do if you need or want a break from classic children’s songs?  In this post, I’d like to share a little bit about one of my all-time-favorite but little-known children’s artists, Caspar Babypants.

The Seattle-based musician (formally known as Chris Ballew) used to be lead singer of the alternative rock group Presidents of the United States of America.  After being nominated for two Grammys, Ballew turned to children’s music under the silly stage name Caspar Babypants.

Many of Caspar’s songs transfer easily to helping clients achieve music therapy goals in individual sessions or groups.  One of Caspar’s most popular songs is “Run, Baby, Run.”  This song can be used to exercise one-step direction following and sustained attention by requiring clients to act out the movements in the lyrics (run, jump, swing, etc.).  If the client needs sensory regulation, the music therapist could choose movements that provide alerting, organizing, or calming sensory stimuli. The simple language in the song lends itself well to children with low receptive language skills, and the client’s name could replace the word “baby.”.  Additionally, instructions embedded in musical stimuli can be easier to process for children with autism spectrum disorder than spoken directions due to abnormal functioning in the left side of the brain.

One of the biggest hits from Caspar’s newest album, Flying High, is “Ants Can’t Dance,” a musical story about the first ant who learned to dance.  This song can be used to work on sustained attention and/or impulse control in a group session when each child waits their turn to attach a visual to a storyboard.  In an individual session, children can demonstrate sustained attention by matching a picture of each character to a storyboard.

Many of Caspar’s songs lend themselves naturally to working on speech goals.  Caspar often uses alliterations such as“More Moles,” “Drowsy Dopey Dozy Dog,” and “Jellyfish Jones.”  These songs provide opportunities for clients to fill in blanks of CVC words (such as dog) or blend words (such as drowsy).  Practicing tongue twisters like “drowsy dopey dozy dog” can be especially useful for children who have mastered CVC sounds but have trouble generalizing to longer words or phrases.

“Everything Has a Song” also provides many opportunities to practice speech sounds listed in the client’s goals.  For example, clients working on producing /b/ can sing about cars that go “beep” or bees that go “buzz.”  This song could also be used for children with auditory sensitivity to desensitize them and let them know when to expect loud noises such as fire alarms, horns, and hand dryers.  When helping clients develop auditory discrimination, music therapists can ask clients identify what sounds are loud, soft, high, low, etc.

I hope this post inspires you to add some Caspar Babypants songs to your repertoire!  Let us know what little-known children’s songs are your favorites.

-Molly, Music Therapy Intern

Thanksgiving Themed Session Plan Inspiration!

One of my new favorite ways to plan music therapy sessions is by centering it around a theme. This is especially fun when it relates to a holiday! I have had a ton of fun looking up and adapting music therapy Thanksgiving ideas, and I wanted to share a couple of them with all of you!

One visual that I found for Thanksgiving is this turkey with feathers visual! I love this one because it can be adapted to fit a huge range of interventions! Here is a photo of the visual. I found it on “Speech Therapy Fun”, which is a website where you can sign up to receive free freebies! Here is the link to the website: https://www.speechtherapyfun.com/

 I adapted this to fit the many needs of my music therapy clients. Here are some ideas for how you could use this visual, or how you could create your own to fit your needs!

• Session Order: Use the visual to order your session plans, while giving clients choice and control over what happens next. To do this, have each feather color corresponds to a specific music therapy intervention that you want to do during the session. By the end of the session, optimally, each client in a group setting would get the opportunity to pick a feather, which is then added to the turkey. For example, the red feather could correspond to a drumming intervention, brown to a sing-a-long, etc. 
• Working on Colors: There are SO many ideas and examples for how you could work on colors using the turkey and feathers. For example, you could have the client work on naming the colors by singing a song prompting the client to find a specific color and add it to the turkey: 

“Can you find the Red feather, red feather, red feather

Can you find the red feather and put it on the turkey!”

I made up my own tune for this-anything you come up with will work! This is a simple activity, that also requires the client to work on their attention while waiting to hear the next color! This could be adapted to fit a wide range of clients’ needs and goals. 

• Color Bells: One way to work on cognitive skills such as focus and attention, as well as making choices, learning colors, or an array of other skills could be to use the feathers to write a song with desk bells. The client or therapist would arrange the feathers (Velcro feathers on) to the turkey, and then the client would play through the song as the colors are arranged from left to right. The client could then rearrange the feathers to be any combination, making this a great intervention with endless possibilities! 

Link to desk bells 

• Working on Social Skills & Asking Questions: For this activity, you could have a corresponding Thanksgiving (or whatever you wanted!) themed question. The client could choose one feather, and then would get the chance to ask or be asked the question. This gives the client a great opportunity to work on asking questions, using follow up questions, and practicing how to engage with those around them, especially during Thanksgiving time! 

Example Thanksgiving Questions: 

What are your favorite Thanksgiving Foods? 

Does your family eat pie on Thanksgiving? What kind?

What are you thankful for this year? 

Lastly, There are some great songs to use for Thanksgiving time. They may be about Thanksgiving itself, the fall season, or songs that center around themes of thankfulness! Here is a list of a couple songs I plan to use in my sessions:

• • What a Wonderful World by Louis Armstrong (Idea: Songwriting activity about things to be thankful for)
  • Thanksgiving Song by Mary Chapin Carpenter
  • Ida, Sweet As Apple Cider by Bing Crosby
  • Autumn Leaves 
  • Albuquerque Turkey (to the tune of “Darling Clementine”)
  • Count Your Blessings Instead of Sheep Irving Berlin Winter Wonderland
  • Over the River and Through the Woods

I hope this post gives you some inspiration for your own Thanksgiving session plans!

-Audrey

 

Tactile Speech Cueing

Producing speech is a complex process that involves coordination between the diaphragm, vocal folds, jaw, lips, tongue, and more.  Speaking requires motor skills that need to be practiced and learned, like riding a bike or shooting baskets (Marisette, 2016). Some of the most common speech and language disorders in our clients are dysarthria and apraxia.  In both disorders, clients know what they want to say, but the quality of their speech can be unclear and difficult to understand, even for close friends and family.

What’s the difference between dysarthria and apraxia?  Dysarthria is characterized by impaired movement of the muscles used for speech production, including the diaphragm, lips, tongue, and jaw (Marisette 2016).  The brain sends motor plans to the articulators, but they struggle to execute them. In contrast, clients with apraxia have difficulty planning and sequencing movements, including movements required for speech (Marisette, 2016).  The brain struggles to send efficient motor plans to the articulators.

Children with dysarthria and apraxia improve speech quality with mass practice (Marisette, 2016).  SLPs commonly use auditory and visual cues to help their clients see and hear how sounds are produced (Marisette, 2016).  There is a growing body of evidence that suggests tactile cues can also be an effective treatment for dysarthria and apraxia (Grigos, Hayden, and Eigen, 2010).

Tactile cues are becoming widely used by speech-language pathologists, related disciplines, and parents.  Tactile cues use a light physical touch on the jaw, tongue, or lips to support and shape correct movement.  There is a specialized touch cue protocol called PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets).  The PROMPT Institute offers specialized training for SLPs (The Prompt Institute, 2019).  However, you don’t need to be a specialized SLP to use touch cues to benefit your client or loved one!  Here are three touch cues Laura M. Kunz, M.A., CCC-SLP uses with her clients to produce the bilabial sounds /m/, /b/, and /p/:

/m/ – lips together, hold 3 fingers in front of lips (horizontally), as making ‘mmmmm’ sound slide fingers across the lips.

/b/ – lips together, hold four fingers in front of lips (vertically), as you say the sound move your fingers in a downward motion.

/p/ – lips together, hold index finger in front of lips (vertically), as you say the sound move your finger in a downward motion.

Music therapists can incorporate touch cues when working on articulation of consonant sounds with clients, especially when using NMT techniques DSLM (Developmental Speech and Language Training through Music) or OMREX (Oral Motor and Respiratory Exercises).  Try it out and see let us know how it works out!

– Molly, Music Therapy Intern

For more information, see the following articles and videos:

Grigos, M., Hayden, D., and Eigen, J. (2010). Perceptual and Articulatory Changes in Speech

Production Following PROMPT Treatment. Journal of Medical Speech-Language Pathology, 18, 46-53.

Kunz, L. (1983). Touch Cue System [PDF file]. Retrieved from:

www.northroyaltonsd.org/Downloads/TouchCue.pdf

Longwood CSD YouTube Channel. (2016, August 20). Childhood Apraxia of Speech: Tactile

Cues [Video file]. Retrieved from: https://www.youtube.com/watch?v=pfTlTRV-yV8

Marisette, C. (2016). PROMPT: A ‘Hands on” Approach to Improving Speech Clarity [Web

page]. Retrieved from https://1to1therapy.ca/prompt/

The Prompt Institute. (2019). What is PROMPT? [Web page]. Retrieved from:

https://promptinstitute.com/page/FamiliesWIP

Developing Cardinality

Learning to count is an essential skill for daily life.  For example, children count to make sure they have both shoes, communicate their age with their hands, and even make sure they get the same number of cookies as their siblings (Sadler, 2009).  I used to think that children who can recite numbers 1-10 in order could count up to ten, but my clients taught me that sorting, counting, and finding the quantity of a set of items is a separate, complex cognitive process.

Counting requires procedural skills and conceptual understanding.  Sadler (2009), a specialist in early childhood mathematics in special education, explains that counters must not only follow the procedure of saying number words in the correct order, but also demonstrate one-to-one correspondence by saying only one counting word as they point to each item. One-to-one correspondence is also known as “tagging” because it requires counters to assign one number to each item.  Lastly, children must understand conceptually that when they count correctly, the final number is the total number of the set. This concept is called cardinality. Children who understand cardinality can count the number of items in a set and answer the question, “How many?”

How do children develop the skills needed for cardinality?  Saddler (2009) synthesized research on the development of cardinality to construct a developmental trajectory.  Both special learners and typically developing children usually acquire cardinality skills in the following order:

The above chart has greatly helped me when working on one-to-one correspondence or cardinality goals with young clients.  This trajectory helps me assess where clients are in this developmental process, as well as create a task analysis for clients.

Music therapists can use counting songs to keep clients engaged and motivated while developing their cardinality skills.  In her article, “The Who and What of Counting,” Plata (2017) writes, “For centuries, children’s rhymes, games, and songs have set the stage for the seemingly effortless acquisition of verbal counting.  Young children happily sing songs in which ducks disappear and monkeys fall off beds.” Music therapists can adapt counting songs, such as “Who Stole the Cookies from the Cookie Jar,” “10 Little Racing Cars,“ “5 Little Ducks,” “10 Little Racing Cars,” “The Ants Go Marching,” “5 Little Apples/Cookies,” and “10 Little Monkeys Jumping on the Bed,” to help clients move through the stages of cardinality, or even write an original song.

The biggest tip I took away from Sadler’s (2009) article is the importance of understanding how counting errors can lead to an incorrect quantity.  Sandler recommends asking children in stages 4 and 5 to check their answers by counting again. If children reach a different answer when checking their work, adults can ask questions such as, “I wonder which answer is right?  How many are there for sure? How can we figure it out? Why do you think you got a different answer that time?” (Sadler, 2009). Asking children to reason their way to the correct answer prepares them for a lifetime of learning.

– Molly, Music Therapy Intern, who never thought she would teach math

 

References

Platas, L. M. (2017). The What and Why of Counting [Web page]. Development and Research in Early Math Education. Retrieved from: https://dreme.stanford.edu/news/why-and-what-counting

Sadler, F. H. (2009). Help! They Still Don’t Understand Counting. TEACHING Exceptional Children Plus, 6(1), n.p.

Rhythmic Speech Cueing and Developmental Speech and Language Training through Music: What are they?

 

Rhythmic Speech Cueing (RSC) and Developmental Speech and Language Training through Music (DSLM) are two Neurologic Music Therapy (NMT) techniques that work on gaining and rehabilitating accurate and fluent speech. While their overall goals overlap, they take distinctly different paths.

DLSM is more often used when speech has not yet been developed to its appropriate level due to a developmental delay, rather than a loss of speech. In short, DLSM is used to habilitate, while RSC is more often used to rehabilitate. Due to the nature of each technique, DLSM is often used with younger populations and RSC with older ones. However, they are not exclusive to those population and can have effective uses, when used appropriately, with their counter “age group”. As always, choosing interventions that are age and developmentally appropriate is imperative.

RSC is much more formulated by a specific protocol. Its purpose is to decrease stuttering and cluttering that may occur in a fluency disorder, control rate of speech to increase intelligibility, and facilitate rhythmic sequencing. Overall, RSC should increase oral motor planning. RSC is effective because of how rhythm entrains to stimulate interaction between auditory and motor systems within the body.

There are three primary steps to RSC. Step 1: Find the initial rate of speech by having the client repeat a pattern of sound such as “pa”, “ta”, etc. Step 2: Slow down talking approximately 60% from the initial rate of speech. Step 3: Repeat functional phrases to a metronome at the new rate. There are two ways in which a phrase can be set to the rhythm. Metered, which is when every syllable of a phrase is beat/tapped out, or patterned, which is when the rhythm is still controlled for clarity in pace of speech, but not every beat is denoted. Patterned phrases should rhythmically imitate the prosody of how a phrase would actually sound, emphasizing what would be in natural speech.

DLSM does not have a specific protocol. It can be carried out in many ways and for multiple purposes. Because of this, it can also be more “fun”, contributing to its lean towards children. In its broadest form, this technique’s purpose is to use music and related materials to enhance and facilitate speech (e.g. singing, playing musical instruments, and combining music, speech, and movement). Broken down, this takes many forms, such as articulation, phrase lengths, and receptive and expressive language comprehension and production. The goals surrounding DLSM can also go beyond simply speech production. Then can often be in conjunction with expanding social and academic skills. For example, learning to ask and answer “WH” questions (i.e. who, what, where, when)

As stated previously, these techniques are not exclusive. They can, in fact, be paired together to increase an intervention potency. For example, I worked with a young client who loved the song “You’re Welcome” from Disney’s Moana. If you are familiar with the tune, you will recall a bridge section of the song that is a rap. We would sit at the piano together, with the lyrics of the song in front of us. I would play the piano as my client sung along. Going at a moderate pace, we would sing through the chorus using the catchy melody and funny lyrics as motivations to practice her articulation in a DLSM fashion. However, when the rap portion would arrive, I would play the chord with each beat of the rhythm (patterned RSC), going even slower for longer phrases and syllabic words, in a modified RSC fashion. We would go through particularly challenging phrases at varying speeds until there was clarity in the articulation. 

Like all techniques, there is a time and place for them. The key is having a solid understanding in order to carry them out in a way that maximized their effects. However, just as understanding is important, so is patients. Techniques are not magic wands and their interventions spells you cast. It may take time and modifications, but diligence on both the client and therapists part will produce results that have life changing consequences. 

-Noriah Uribe

Family Mapping

Before internship, I had not thought about clients in the context of their families and the larger community.  Knowing the dynamics, stressors, coping skills, and strengths of the client’s family can help therapists know how to best serve the client.  When the client’s family feels that their priorities and goals are understood, it can help build rapport and keep the lines of communication open.  Open communication is important to make sure there is consistency between home, school, and other therapies.

Some therapists create visual family maps for their clients.  Family maps can show not only outside resources such as extended family, friends, support services, or even hobbies, but also dynamics between immediate family members.  Here’s an example of a family map from Bennett:

When I learned about family mapping, I wondered, Do I need to draw an elaborate diagram for every child I work with?  When and how do I gather this information without interrogating parents?  However, I learned that most music therapists create informal family maps gradually as families disclose more information about their lives.

I was most surprised to learn from Bennett’s (2007) writing that families tend to have stronger connections with informal support than formal support.  Informal support includes extended family, friends, neighbors, faith community, etc. During a challenge or crisis, families will usually reach out to their informal support system first.  Formal support includes teachers, doctors, therapists, and other professionals assisting the family. Formal support, such as a child’s teacher, tends to change more frequently than informal support, such as extended family.

I learned that family mapping is not necessarily another step to do during assessment or reevaluation of clients, but another lens through which to see the client, their family, and their larger network of support.  I find that piecing together informal family maps helps me see the bigger, holistic picture of my clients, their need areas, and their overall functioning, which helps me be a more effective music therapist.

– Molly, Music Therapy Intern

Creating a Hierarchy for Learning

Making sure that clients learn the skills you are working on and are able to generalize them to other settings and in their day to day life is essential for their growth! One effective tool for structuring this learning is using a Hierarchy. Below is the layout of a Learning Hierarchy from The Music Therapy Center of California that leads these clients through these steps. This hierarchy helps clients to start by learning a skill through music and then eventually be able to translate it into their daily life. This uses a scaffolding approach, which starts with support and direction, and eventually fades out so that clients are able to use these skills on their own. 

A Music Therapy Learning Hierarchy: for Children with ASD: by the Music Therapy Center of California

Interact and learn: First, listen to the song. Give clients the opportunity to play or dance along, and eventually sing-a-long as they get to know the lyrics. 

• Example: if working on a social skills song about what to do when you first meet a stranger, you would first introduce the song to the client. You could play along on instruments and dance along with the client. 
• Example Lyrics: When you meet someone for the first time, Smile at them and say “Hi!”

Pause for Understanding: Use song review, by pausing the recording or your playing at the end of a phrase and see if the client is able to fill in the words. This gives clients an opportunity to practice the lyrics without any help, and is a cognitive exercise, requiring them to stay engaged and focused! When they are ready, you can also encourage clients to sing the entirety of the song karaoke style!

• Example: Sing the song again with the client, but leave out the final phrase. With the example song given above, you could sing the full phrase but leave out “Hi!” and the end, and have the client fill it in to check for understanding. 

Fade the Music: Next, you take out the melody entirely, and you chant the lyrics. You can do this while drumming a steady beat, or while tapping along. If the client is having difficulty remaining on beat, you can tap on their arm/shoulder to help them entrain to the rhythm of the chant. This helps clients on their way to generalizing this skill, by removing the musical melody component. Lastly, you remove the chant entirely. Instead, clients simply say the lyrics, and they do not have to be in the rhythm of the song. You can use visuals to have clients practice putting the steps of the skills they are learning in order, or you can practice by acting the skill out together.

• Example: First, remove the melody and simply chant “when you meet someone for the first time, smile at them and say hi”. Once this has been mastered, remove the chant and rhythm and simply say the lyrics: “When you see someone for the first time, you can smile and say hi!”. You could add in scenarios and act out this scenario by pretending you are a stranger that they have just met, so they can practice how to behave. 

Generalize: In this final step, the goal is to generalize the skill to other areas of the client’s life, outside of your music therapy session. To add another level of practice, you can have the client practice this skill with someone other than you (another therapist, family member, or friend).

• Example: Ask another therapist or nearby individual to come into the therapy session, so that the client can practice how to say hello to someone new! Or bring the client around to surrounding businesses if possible, so they have more opportunity for practice. 

 

Some tips to help increase success for the client: 

• Create visuals for your song (steps to take, scenarios, lyrics) 
• Create a video acting out the skill you are working on 
• Practice with costumes on 
• Use a microphone to encourage client to sing along and practice lyrics 
• Create actions/motions to go along with your song 
• Create a dance for your song that corresponds with lyrics 
• Practice the skill in new places/new scenarios

You will know that you have been successful when your client goes from simply singing along to the song, to being able to use this skill in their everyday life! Being able to generalize these skills outside of their music therapy session is an important goal to work towards. 

If you’d like to see these techniques in action, watch the following video, created by The Music Therapy Center of California: https://www.youtube.com/watch?v=zqb_Pxd8hyY&feature=youtu.be

Imagine Child Magazine has an article about this topic, it is linked here: http://issuu.com/ecmt_imagine/docs/imagine_7_1__2016/97?e=1466273/39224725

See you in the next post!

Audrey

 

Teaching Social Skills Through Song: A Music Therapy Learning Hierarchy for Children with ASD. (2016). Retrieved November 1, 2019, from https://issuu.com/ecmt_imagine/docs/imagine_7_1__2016/97?e=1466273/39224725

 

Music Therapy Halloween Intervention Ideas!

Hello everyone, welcome to another blog post!

I realize that it is now November, but I still wanted to share some Halloween music therapy intervention ideas so that you all can start preparing for next year’s Halloween! All credits go to one of our wonderful music therapists, Esther Hood! She is the queen of coming up with new and creative intervention ideas for our clients.

One of the best things about these interventions is that they can be adapted for individual and group clients. We used these with our individual clients with autism, along with clients with special needs at group homes (6-8 people), and clients with special needs at a day facility (20-30 people). All of these interventions are based on attention goals, more specifically, MACT (for those of you who are familiar with NMT!) I will specify later on what goals we used for each intervention. 

1. Halloween Hike

This is such a fun song to use, all of our clients really enjoyed all of the sound effects and interactive visuals! The lyrics to the song can be found here. A recording of this song can be found here. For this intervention, we worked on sustained attention. Visuals are passed out to the clients, each person either getting 1 or 2 depending on the size of the group. Visuals can be found here. If there are not enough visuals to go around, you can have the rest of the clients participate by making the sound effects and listening for what is next in the song! During the Halloween Hike, different objects are spotted throughout the song, and it is the clients’ job to pay attention to when their object is called, and then hold it up for the whole group to see, and then drop it in a plastic cauldron (if available), or a frame drum. For example, the first thing found on the hike is an owl, and whoever is holding the owl, they hold it up, and then drop it in the cauldron. 

You can also choose to make noises that associate with each object as another way to engage your clients, such as hooting like an owl. Continue this until all the objects have been called until the end of the song. During the line, “let’s get out of here!”, you can rapidly strum the guitar and have the clients run in place. This intervention can also be easily adapted for an individual client, but instead of giving them all 12 of the visuals at once, you can split them up into a field of 3 or more, depending on your client. 

 

      2. ~Spooky~ Bear Went Over The Mountain

This intervention takes the traditional song, “Bear Went Over the Mountain”, and gives it a spooky twist by playing the song in a minor key! I have been playing it in A minor, and the chords are I-IV-V. For this intervention, you can work on several different goals. I have used it with one of my clients who has a goal about decision making (MEFT), or you can also use this as another attention intervention (MACT). You may also choose to use this in a group setting. The visuals needed for this intervention can be found here and here. 

For this intervention, the client gets the opportunity to choose the lyrics that go into the song. The traditional version has the lyrics, “the bear went over the mountain”, but for this intervention, the client chooses words that replaces “bear” and “mountain”, with Halloween-related objects. For example, one of the flash cards says “bat” and “black cat”, which you would then insert into the song, and sing:

“The bat flew over the black cat, 

the bat flew over the black cat, 

the bat flew over the black cat 

to say Happy Halloween!” 

You can engage the client even further by having them sing along with you, or pausing before the object, and having them read the card out loud to you as a fill-in-the-blank exercise. 

 

      3. Hound Dog, but with monsters! 

 Another great intervention that I’ve seen Esther use is a piggyback version of the song “Hound Dog”. She first starts by showing the group pictures of different monsters related to Halloween, such as Frankenstein, a mummy, a vampire, etc. She asks the group (or can also be an individual client), what the monster is, and then what is something that they would do. For example, a common action for a vampire is to flip their cape. After deciding on an action, have clients mirror the action of the monster. Then, you can start singing “Hound Dog”, but insert the name of the monster into the song. Here is an example:

“You ain’t nothing but a vampire,

Flipping your cape all around [pause for action], 

You ain’t nothing but a vampire,

Flipping your cape all around [pause for action],

Well you ain’t never caught a rabbit,

And you ain’t no friend of mine!”

 

   4. Ghostbusters!

One of the most iconic and recognizable Halloween songs of all time is Ghostbusers! This is a great intervention that I have used with both older adults and adults with special needs. For older adults, this can work on short term memory and gross motor movements, and with adults with special needs, this can work on attention and gross motor movements.

For this intervention, I play a recording of Ghostbusters, and explain to the clients that every time they hear “Ghostbusters”, to raise their shakers high up in the air. If they have never heard the song before, I like to do a few trial runs by singing, “who you gonna call… Ghosbusters!” and modelling holding my shaker high up in the air. For adults with special needs, you can also use instruments, or you can use visuals of ghosts or other Halloween related objects. 

Throughout the entire song, you can explain to your clients that they can shake along with their instruments to get some exercise, and to be sure they are listening for their musical cues of when to hold up their shakers.

I’d love to hear from you all! What are some Halloween interventions that you’ve used in your music therapy sessions, or what are some of your favorite holidays to plan themes around? 

See you in the next post!

– Juliana Hsu